肠系膜上动脉血流动力学改变与肝硬化腹水相关性的临床研究

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摘要目的探讨肠系膜上动脉（SMA）血流动力学改变与肝硬化腹水的相关性。方法选择2018年11月～2020年11月江西省萍乡市第二人民医院收治的30 例肝硬化腹水患者作为观察组，另选择同期在江西省萍乡市第二人民医院进行体检的30 例健康人员作为对照组，两组受试对象均采用彩色超声显像仪行SMA 血流动力学检测，且观察组患者经综合治疗腹水消失后1 周再进行彩色超声显像仪检测，比较健康组及观察组患者经治疗腹水消退前后的SMA 内径、血流速度、血流量、SMA 脉动指数（SMA-PI）和SMA 阻力指数（SMA-RI）等SMA 血流动力学指标水平。结果观察组患者的SMA 内径长于对照组，血流速度快于对照组、血流量多于对照组，SMA-PI、SMARI 均低于对照组，差异均有统计学意义（P＜0.05）。观察组患者经治疗腹水消退后的SMA 内径短于腹水消退前，血流速度慢于腹水消退前，血流量低于腹水消退前，SMA-PI、SMA-RI 高于腹水消退前，差异有统计学意义（P＜0.05）。Logistic 多因素分析结果显示：SMA 内径（β=0.74，OR=1.18，95%CI=1.05～1.97）、血流速度（β=1.49，OR=2.04，95%CI=2.01～2.69）、血流量（β=1.26，OR=2.09，95%CI=2.03～2.78）、SMA-PI（β=-0.26，OR=0.68，95%CI=0.60～0.83）、SMA-RI（β=-0.31，OR=0.72，95%CI=0.69～0.98）是引发肝硬化腹水形成的影响因素（P＜0.05）。结论肝硬化患者SMA 高动力循环为腹水形成的原因之一，为预防肝硬化腹水的发生或改善肝硬化腹水患者预后，需尽早改善肝硬化患者的肠系膜动脉血流高动力循环状态。

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	刘蓉
	陈清
	熊美娥

关键词 ：肠系膜, 动脉血流动力学, 肝硬化, 腹水, 相关性

Abstract：Objective To investigate the relationship between the hemodynamic changes of superior mesenteric artery(SMA)and ascites due to cirrhosis.Methods Thirty patients with liver cirrhosis and ascites admitted to the Second People′s Hospital of Pingxiang City,Jiangxi Province from November 2018 to November 2020 were selected as the observation group,and 30 patients who underwent physical examination in the Second People′s Hospital of Pingxiang City,Jiangxi Province during the same period were selected as the control group.Both groups of subjects used color ultrasound imaging to perform superior mesenteric artery hemodynamic testing,and the observation group received color ultrasound 1 week after the disappearance of ascites after comprehensive treatment.The hemodynamic index levels of superior mesenteric artery which were(SMA)inner diameter,blood flow velocity,blood flow,SMA pulsation index(SMA-PI)and SMA resistance index(SMA-RI)were compared between the healthy group and observation group before and after treatment.Results The inner diameter of the SMA of the observation group was longer than that of the control group,the blood flow was faster than that of the control group,and the blood flow was more than that of the control group,the SMA-PI and SMA-RI of the observation group were lower than those of the control group,the differences were statistically significant(P＜0.05).In the observation group,the inner diameter of the SMA after treatment for ascites resolution was shorter than that at before ascites resolution,blood flow was slower than that at before ascites resolution,blood flow was lower than that at before ascites resolution,and SMA-PI and SMA-RI were higher than those at before ascites resolution,the differences were statistically significant(P＜0.05).Logistic multivariate analysis results showed that SMA inner diameter(β=0.74，OR=1.18，95%CI=1.05-1.97),blood flow velocity(β=1.49，OR=2.04，95%CI=2.01-2.69),blood flow(β=1.26，OR=2.09，95%CI=2.03-2.78),SMA-PI(β=-0.26，OR=0.68，95%CI=0.60-0.83),SMARI(β=-0.31，OR=0.72，95%CI=0.69-0.98)were the influence factors for the formation of ascites due to liver cirrhosis(P＜0.05).Conclusion The superior mesenteric artery hyperdynamic circulation in patients with liver cirrhosis is one of the reasons for the formation of ascites.In order to prevent the occurrence of cirrhotic ascites or improve the prognosis of patients with cirrhotic ascites,it is necessary to improve the hyperdynamic circulation of mesenteric artery blood flow in patients with liver cirrhosis as soon as possible.

Key words： Mesenteric Arterial hemodynamics Liver cirrhosis Ascites Correlation

基金资助:江西省萍乡市科技计划项目（2019PY099）

引用本文:

刘蓉；陈清；熊美娥. 肠系膜上动脉血流动力学改变与肝硬化腹水相关性的临床研究[J]. 中国当代医药, 2021, 28(13): 61-63.
LIU Rong；CHEN Qing；XIONG Mei-e. Clinical study on the correlation between the hemodynamic changes of superior mesenteric artery and ascites due to cirrhosis. 中国当代医药, 2021, 28(13): 61-63.

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http://dangdaiyiyao.com/CN/ 或 http://dangdaiyiyao.com/CN/Y2021/V28/I13/61

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